Evolution in abdominal trauma: Ege University experience
Özer Makay, Özgür Fırat, Barış Gürcü, Taylan Sezer, Gökhan İçöz
Ege Üniversitesi Tıp Fakültesi Hastanesi, Genel Cerrahi AD, Bornova, İZMİR
Purpose: Since the last two decades there has been an evolution in the diagnosis and management of trauma. A shift has also been seen in the etiological pattern of trauma. In this study, we evaluated the reflection of changes in abdominal trauma on our patients.
Materials and methods: A total of 601 adult penetrating and blunt trauma patients admitted to our clinic between July 1994 - September 2005 were evaluated and compared retrospectively between two different time intervals (Period I= July 1994 – December 1999 and Period II = January 2000 – September 2005).
Results: Eighty-three percent of the patients studied were male while 17% were female. The mean age was 33.4 ± 12 years. There were 50,7% injuries due to blunt and 49,3% due to penetrating trauma. The main cause of penetrating trauma was stabbing (31.4%), while road accident was the main cause of blunt trauma (42%). Penetrating injury increased from 41.5% to 56% (p<0.05), while blunt trauma rates decreased from 58% to 44% (p<0.05). When comparing DPL rates between two different time intervals it was observed that the indication of DPL decreased significantly in period II from 31.3% to 10.6% (p<0.05). Nonoperative management, which was started in period II, was carried out in 65 (24.7%) patients. Diagnostic laparoscopy was used in 11 (7.9%) of the 153 patients in period II.
Conclusion: Abdominal trauma is in evolution with respect to the developmental technology and changing algorithms. It is logical that this change will effect surgical education and practice.
Keywords: Abdominal trauma, surgery, nonoperative management, diagnostic peritoneal lavage